Eisenmenger’s syndrome natural history: Difference between revisions
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==Natural History== | ==Natural History== | ||
Patients with [[Eisenmenger's syndrome]] pass through the following stages: | Patients with [[Eisenmenger's syndrome]] pass through the following stages<ref name="pmid95564692">{{cite journal| author=Vongpatanasin W, Brickner ME, Hillis LD, Lange RA| title=The Eisenmenger syndrome in adults. | journal=Ann Intern Med | year= 1998 | volume= 128 | issue= 9 | pages= 745-55 | pmid=9556469 | doi=10.7326/0003-4819-128-9-199805010-00008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9556469 }}</ref>: | ||
* An underlying heart defect that initially allows a [[left-to-right shunt]] between the left and right sides of the heart | * An underlying heart defect that initially allows a [[left-to-right shunt]] between the left and right sides of the heart. | ||
* The development of [[pulmonary hypertension]] | * The development of [[pulmonary hypertension]]. | ||
* [[Polycythemia]], an increase in the number of [[Red blood cell|red blood cells]] | * [[Polycythemia]], an increase in the number of [[Red blood cell|red blood cells]]. | ||
* Finally, a reversal of the left-to-right shunt so that there is a [[right-to-left shunt]] | * Finally, a reversal of the left-to-right shunt so that there is a [[right-to-left shunt]]. | ||
Therefore, they may present with a history of symptoms for each of these stages. | Therefore, they may present with a history of symptoms for each of these stages. | ||
==Complications== | ==Complications== | ||
The complications of Eisenmenger's syndrome include: | The complications of Eisenmenger's syndrome include<ref name="pmid9556469">{{cite journal| author=Vongpatanasin W, Brickner ME, Hillis LD, Lange RA| title=The Eisenmenger syndrome in adults. | journal=Ann Intern Med | year= 1998 | volume= 128 | issue= 9 | pages= 745-55 | pmid=9556469 | doi=10.7326/0003-4819-128-9-199805010-00008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9556469 }}</ref>: | ||
*[[Intracranial hemorrhage]] | *[[Intracranial hemorrhage]] | ||
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*[[Infection]] ([[Brain abscess|cerebral abscess]]) | *[[Infection]] ([[Brain abscess|cerebral abscess]]) | ||
*[[Renal failure]] | *[[Renal failure]] | ||
*[[High risk pregnancy]] and fetal loss. | |||
*[[Sudden cardiac death|Sudden death]] | *[[Sudden cardiac death|Sudden death]] | ||
==Prognosis== | ==Prognosis== | ||
* How well the infant or child does depends on: | * How well the infant or child does depends on<ref name="pmid28430906">{{cite journal| author=Hjortshøj CMS, Kempny A, Jensen AS, Sørensen K, Nagy E, Dellborg M et al.| title=Past and current cause-specific mortality in Eisenmenger syndrome. | journal=Eur Heart J | year= 2017 | volume= 38 | issue= 26 | pages= 2060-2067 | pmid=28430906 | doi=10.1093/eurheartj/ehx201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28430906 }}</ref>: | ||
** whether another medical condition is present | ** whether another medical condition is present | ||
** the age at which [[high blood pressure]] develops in the [[Lung|lungs]]. | ** the age at which [[high blood pressure]] develops in the [[Lung|lungs]]. | ||
* Patients with [[Eisenmenger's syndrome]] can live 20 to 50 years. | * Patients with [[Eisenmenger's syndrome]] can live 20 to 50 years. | ||
*The predictors of mortality in [[Eisenmenger's syndrome]] include<ref name="pmid27979875">{{cite journal| author=Kempny A, Hjortshøj CS, Gu H, Li W, Opotowsky AR, Landzberg MJ et al.| title=Predictors of Death in Contemporary Adult Patients With Eisenmenger Syndrome: A Multicenter Study. | journal=Circulation | year= 2017 | volume= 135 | issue= 15 | pages= 1432-1440 | pmid=27979875 | doi=10.1161/CIRCULATIONAHA.116.023033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27979875 }}</ref>: | |||
**Age | |||
**Pretricuspid shunt | |||
**[[Oxygen saturation]] at rest | |||
**Presence of [[sinus rhythm]] | |||
**Presence of [[pericardial effusion]] | |||
==References== | ==References== | ||
Revision as of 15:28, 20 January 2020
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Eisenmenger’s syndrome Microchapters |
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Diagnosis |
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Eisenmenger’s syndrome ACC/AHA Guidelines for Evaluation of Patients |
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Treatment |
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Eisenmenger’s syndrome natural history On the Web |
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American Roentgen Ray Society Images of Eisenmenger’s syndrome natural history |
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Risk calculators and risk factors for Eisenmenger’s syndrome natural history |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]
Overview
The complications of Eisenmenger's syndrome include intracranial hemorrhage, stroke, congestive heart failure, angina pectoris, hyperviscosity syndrome, infection (cerebral abscess), renal failure, and sudden death. How well the infant or child does depends onwhether another medical condition is present and the age at which high blood pressure develops in the lungs. Patients with Eisenmenger's syndrome can live 20 to 50 years.
Natural History
Patients with Eisenmenger's syndrome pass through the following stages[1]:
- An underlying heart defect that initially allows a left-to-right shunt between the left and right sides of the heart.
- The development of pulmonary hypertension.
- Polycythemia, an increase in the number of red blood cells.
- Finally, a reversal of the left-to-right shunt so that there is a right-to-left shunt.
Therefore, they may present with a history of symptoms for each of these stages.
Complications
The complications of Eisenmenger's syndrome include[2]:
- Intracranial hemorrhage
- Stroke
- Congestive heart failure
- Angina Pectoris
- Hyperviscosity syndrome
- Infection (cerebral abscess)
- Renal failure
- High risk pregnancy and fetal loss.
- Sudden death
Prognosis
- How well the infant or child does depends on[3]:
- whether another medical condition is present
- the age at which high blood pressure develops in the lungs.
- Patients with Eisenmenger's syndrome can live 20 to 50 years.
- The predictors of mortality in Eisenmenger's syndrome include[4]:
- Age
- Pretricuspid shunt
- Oxygen saturation at rest
- Presence of sinus rhythm
- Presence of pericardial effusion
References
- ↑ Vongpatanasin W, Brickner ME, Hillis LD, Lange RA (1998). "The Eisenmenger syndrome in adults". Ann Intern Med. 128 (9): 745–55. doi:10.7326/0003-4819-128-9-199805010-00008. PMID 9556469.
- ↑ Vongpatanasin W, Brickner ME, Hillis LD, Lange RA (1998). "The Eisenmenger syndrome in adults". Ann Intern Med. 128 (9): 745–55. doi:10.7326/0003-4819-128-9-199805010-00008. PMID 9556469.
- ↑ Hjortshøj CMS, Kempny A, Jensen AS, Sørensen K, Nagy E, Dellborg M; et al. (2017). "Past and current cause-specific mortality in Eisenmenger syndrome". Eur Heart J. 38 (26): 2060–2067. doi:10.1093/eurheartj/ehx201. PMID 28430906.
- ↑ Kempny A, Hjortshøj CS, Gu H, Li W, Opotowsky AR, Landzberg MJ; et al. (2017). "Predictors of Death in Contemporary Adult Patients With Eisenmenger Syndrome: A Multicenter Study". Circulation. 135 (15): 1432–1440. doi:10.1161/CIRCULATIONAHA.116.023033. PMID 27979875.